The Research Management Committee is faced with the challenges of endorsing 7 -8 research proposals for technical review and soliciting one proposal each member institution of the Cordillera Regional Health Research and Development Consortium (CRHRDC).  Engineer Nathan Lubrica, chairman of the Committee, expressed this during the Executive meeting held May 6, 2015 at the Casa Vallejo, Baguio City.

Because of this, the Committee has to re-strategize strongly and aggressively their campaigns.  They propose the following:

• contact  research proponents to determine the status of their research proposals with the assistance of the secretariat;

• request each member institution to present one research proposal for review by the Committee members during their regular meeting;

• reach out to all state universities and colleges in the region through social marketing and render technical  assistance together with the Capability Building Committee and other CRHRDC members;

• expedite research evaluation by determining the technical and ethical soundness of the proposals to be undertaken with the Ethics Review Committee;

• conduct a write shop by the second quarter  to enable proponents put details on their proposals; and

• if so required, they make themselves available for consultation.

Currently, the Committee has designed a flowchart to fast tract the approval of research proposals.  Thus, delayed evaluation should not be a problem to proponents in receiving the feedback.   It is also in the Committee where two member-institutions (Saint Louis University and University of the Cordilleras) have researches funded by PCHRD and are ready for implementation subject to MOA signing.  The experience in accessing the fund could serve as testimony to inspire other institutions to come up with their own.

Meanwhile, Regional Director  Julius Caesar Sicat of the Department of Science and Technology shared  on how the DOST was able to generate several municipal S&T projects beyond the target for their grant-in-aid project and for which the Committee could adopt without sacrificing the quality of the proposal.

“What we did, we require the mayors to appoint point persons in their municipality.  Then we call these people for trainings on project identification, research proposal preparation, among others.  After equipping them the necessary skills, we call them for a two-day write shop. We also bring templates for them to use as bases for the write shop, “Director Sicat related.

“I would like to see at least one or more research proposals this year funded by PCHRD, “CRHRDC chairman and UP Baguio Chancellor Raymundo D. Rovillos underscored during the work planning activity of the consortium on January 20, 2015 at the Crowne Legacy Hotel, Baguio City. This according to him is possible through closer coordination between and among the committees as well as the active engagement of individual and institutional members.

Also, the efforts of the four technical committees (Research Management, Ethics, Capability and Training, Research Utilization) combined are aligned towards its attainment to be facilitated by innovative mechanisms instituted last year. These efforts yield the following priority action areas:

Sustain capacity building for individual and institution members.  The Capacity Building Committee in coordination with theEthics Committee will equip in two phases the CRHRDC members about the requirements for ethical review of health research.  The first phase is an Orientation on Ethics to enable the members of a common understanding about the ethical considerations of doing a research as this involves human participants as respondents.  This is to be followed by Training on Ethics which is the second phase.  On this, other and more stakeholders will be invited to participate.  According to Joint Memorandum Order 2012-001, all health researches involving human subjects must undergo ethical review and clearance before implementation to ensure the safety, dignity and well-being of research participants. The members of the Ethics Committee will serve as resource persons for the orientation while the Philippine Health Research Ethics Board will act as resource persons for the training.

Moreover, the Capacity Building Committee is expected to conduct a series of capability trainings on varied topics such as research proposal preparation, data analysis using quantitative and qualitative methods, and how to prepare powerful presentations.  All these will shepherd participants enhance their capacities until they are ready to present their paper in conferences and forums.     There is also the project BINNADANG, a coaching and mentoring type whose participants will be taught hands on data collection methods (e.g.  facilitating key informant interviews and focus group discussions).   

Meanwhile, the Research Utilization Committee will benchmark best practices of successful health consortium and aims at learning in greater heights about research dissemination, utilization and advocacy.   This will not only cover experiential learning of innovative processes, products, and services but will also   identify replicable practices for CRHRDC’s adoption and implementation.

Update the Regional Health Research Unified Agenda (RHURA).  This will be spearheaded by the Research Management Committee.  The RHURA will serve as a guide for higher education institutions in generating their own institution research agenda containing thematic areas for basic and applied research.  The students and faculty members alike will use this as a reference in selecting researchable topics.  Main inputs to the RHURA formulation shall be drawn from the national and regional priorities.

On the part of CRHRDC, this will be used as basis for calling incoming proposals.  A flowchart is now in place showing the approval process from evaluation to funding.          

Intensify advocacy through dissemination and utilization of health researches.  Under the Research Utilization Committee, the Regional Health Research Conference is conducted annually.  This is usually an avenue to (1) provide an interactive space for graduate and undergraduate students to present their completed studies (thesis, seminar paper), (2) disseminate to the public research- based understanding and solutions to health and well-being problems, (3) be a source of studies for knowledge sharing, and (4) choose papers for the annual Philippine National Health Research Systems (PNHRS) Week celebration.  This year, instead of the PNHRS, the Global Forum on Research Innovation for Health will be celebrated on August 24-27, 2015 in Manila.

“The forum is geared to help participants acquire new understandings of current and future challenges in global health, as we together find appropriate solutions sourced from all corners of the world,” says Dr. Mario Montejo, the Secretary of the Department of Science and Technology (as retrieved from http://www.forum2015.org)

Considered a milestone in the making, the committee is expected to reach out to the communities whose people can benefit from the results of studies in improving their lives.  

Lastly, the regional Health Research and Development Information Network (HERDIN) will be strengthened and becomes fully operational filled up with completed researches for use by the research community and the general public.

This was revealed during the Orientation on Research Proposal Preparation on April 17, 2015 at the University of the Philippines Baguio.  Said agenda was initiated in the region by the Cordillera Regional Health Research and Development Consortium (CRHRDC) in consultation with health sector stakeholders.   

The research agenda is categorized into four themes: health financing, health service delivery, socio-environment concerns, and health technology development.  Research topics are also identified under each theme:

Health Financing

• Financial risk protection (Pharmaco-economics on cardio-vascular diseases and diabetes, assessment of health benefits, social insurance- out-patient benefits and no balance billing)

Health Service Delivery

• Health service assessment on vulnerable groups (eg.OFW)
• Complementary and alternative medicine
• Indigenous knowledge systems and practices
• Health promotion
• Communicable and Non-communicable diseases

Socio-environment Concerns

• Environment and climate change
• Health social sciences
• Environment and sanitation

Health Technology Development

• Drug discovery and development
• Information and communications technology for health

With its availability, higher education institutes (HEIs) can use it as guide for coming up with relevant studies, policy makers can tap the results of the studies as evidence for their decision-making to approve programs and projects, and the Commission on Higher Education can incorporate it in the National Higher Education Research Agenda for HEIs adopt in formulating their own institution research agenda.

The CRHRDC approved it on February 17, 2015 in Baguio City with inputs from the higher education institutes (University of the Philippines Baguio, University of the Cordilleras, University of Baguio, Saint Louis University, Cordillera Career Development College, Benguet State University), Commission on Higher Education, the Department of Health, Baguio General Hospital and Medical Center, National Economic and Development Authority,  Department of Science and Technology, and the Philippine Council for Health Research and Development.     

This is exactly what the Ethics Review Committee (ERC) members did during the Orientation on Ethics Review for CRHRDC members at UP Baguio, Sarmiento Hall, Baguio City last February 17, 2015.  No less than the members of ERC who served as resource persons - Dr. Eleonor Cuarte (Baguio General Hospital and Medical Center)- The Chair,  Dr. Robert Tolentino (Saint Louis University),  Dr. Lloyd Orduna  (University of Baguio) and Dr. Nicolas Gordo (formerly of the Department of Health-Cordillera).

The orientation has two objectives.  One is to ensure common understanding among the participants who are members of the consortium.  Dr. Cuarte defined key concepts and the Basic Ethical Principles, differentiated research vs. therapy,  and shared classical research Ethics practices (e.g. Tuskegee Trial on Syphilis, Nazi experiments) as well as personal experiences (i.e. implementation challenges, unique ERC membership compared to other committees, rigid training qualifications).   

The other objective is to increase their level of awareness so they can help institution members establish their own Institutional Ethics Review Committee (IERC) based on a joint memorandum circular between and among the Department of Science and Technology, Department of Health, Commission on Higher Education, and University of the Philippines- National Institute of Health.  

From Dr. Cuarte’s lecture, there are seven principles the Ethics reviewer has to consider in evaluating research proposals.  These are, the research proposal:  

• should have a social or scientific value to existing body of knowledge;
• is scientifically valid indicated by research methods employed, among others ;
• observes fair subject selection;
• demonstrates favorable risk-benefit ratio;
• goes through an independent review;
• secures informed consent assuring participants’ (the respondents)  willingness to participate in the study; and
• gives due respect to human subjects’ objection to participate at any stage of the study.

Ethics review in research reduces the possibility of exploitation of human resources (particularly in clinical research), promotes social welfare and contextualizes local settings.  “Because a lot of knowledge is from western countries so we need to know its applicability and appropriateness in the locality,” she explained.

Since all institutions are doing research, it is imperative that these institutions have their own IERCs.  “As of now, it is only the ERC of CRHRDC who is reviewing researches including those coming from other institutions,” Dr. Robert Tolentino reported. “But in the long run as indicated by Philippine Health Research Ethics Board (PHREB), all regional ERC will no longer be an ERC but becomes an Ethics Review Board, whose function will be policy-making and oversight in the region, ” Dr. Nick Gordo elaborated.

“There are three levels of accreditation for the IERCs- Level 1, Level 2, and Level 3.  It so happens that the Baguio General Hospital and Medical Center (BGMC) is a hospital thus it is classified as Level 3.  The BGHMC was recently granted accreditation to do Ethics review. But for IERCS, we can only be Level 1 and Level 2, not Level 3 because we are not conducting clinical trials, ” Dr. Lloyd Orduna assured the higher education institutions present during the orientation on might be the negative effect of the process to them. 

So what needs to be done?  Dr. Cuarte advised for members to go for accreditation by PHREB. “Get the training, identify the members and form yourself a committee, draw up your manual of operations, then sit down and review,” she simply put forward. 

The orientation was able to meet its objectives of levelling off and enlightenment. To some participants, it is not really that mystical.  It is a matter of knowing the lines drawn  between an Ethical and technical review. Based on the seven principles, there are items the Research Management Committee has been using for their technical review.  They will just have to be conscious of the dimensions of Ethics review.   

Dr. Nick Gordo also pointed out in conclusion, “all that the technical reviewers do is a documentation of the activity and has taken preparation of the research and that the ERC should be part of the deliberation.”